In accordance
with 5 CFR 1320, the information collection is not approved at this
time. Prior to publication of the final rule, the agency should
provide to OMB a summary of all comments received on the proposed
information collection and identify any changes made in response to
these comments.
Inventory as of this Action
Requested
Previously Approved
05/31/2014
36 Months From Approved
05/31/2014
52
0
52
1,976
0
1,976
0
0
0
Section 1923(a)(2)(D) of the Act
requires the States to submit an annual report that identifies each
DHS payment under the State's Medicaid program in the preceding
fiscal year and the amount of DSH payments paid to that hospital in
the same year and such other information as the Secretary
determines necessary to ensure the appropriateness of DHS payments.
The information supplied will satisfy the requirements under
section 1923(a)(2)(D) of the Act as well.
There are proposed changes to
the burden based on the a notice of proposed rulemaking
(CMS-2367-P) that would require the submission of additional
information under section 1923(j)(1) of the Social Security Act. To
ensure the most accurate burden estimate, there are changes to the
hours and wages based on our review of State submissions under
section 1923(j) of the Social Security Act. Additionally, the
number of respondents has been corrected from 52 to 51 (all 50
states and the District of Columbia). Hours The information
submitted by each State is required annually, beginning at the end
of the first quarter of the fiscal year following the reporting
period. The notice of proposed rulemaking (CMS-2367-P) would
require additional information hospital specific payment data from
States related to the disproportionate share hospital program. We
estimate that it would take an additional 4 hours per state (from
38 approved hr to 42 total hr) to complete the DSH reporting
spreadsheets. Wages We used the following hourly labor rates and
estimated the time to complete each task: $51.00/hr and an
additional 102 hr (1,071 total hours) for management and
professional staff to review and prepare reports, and $28.77/hr and
an additional 102 hr (1,071 total hours) for office staff to
prepare the reports. We estimate that the proposed changes will
require an additional cost of $10,404 (or $85,434 total) based on
the additional 204 (4 x 51) annual hours for all states and the
District of Columbia (or 2,142 total hr).
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.